Somatisation in Primary Care in Spain

1996 ◽  
Vol 168 (3) ◽  
pp. 344-348 ◽  
Author(s):  
Antonio Lobo ◽  
Javier García-Campayo ◽  
Ricardo Campos ◽  
Guillermo Marcos ◽  
Ma Jesus Pérez-Echeverria ◽  
...  
Keyword(s):  
Primary Care ◽  
Mini Mental State Examination ◽  
Somatoform Disorders ◽  
Sociodemographic Factors ◽  
Second Phase ◽  
Demographic Differences ◽  
Two Phase ◽  
Psychiatric Interview ◽  
Dsm Iv ◽  
State Examination

BackgroundThis is the first attempt to study the prevalence and clinical characteristics of somatisation (ST) in a representative primary care sample in Spain.MethodThe sample consisted of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, Spain, examined by two-phase screening. First phase (lay interviewers): Spanish versions of GHQ–28, CAGE questionnaire, substance abuse, Mini-Mental State Examination. Second phase (research clinicians and psychiatrists): Standardised Polyvalent Psychiatric Interview, which permits the reliable coding of Bridges & Goldberg's ST criteria.ResultsThe prevalence of somatisers was 9.4% (34.5% of the cases) and most patients (68.7%) were diagnosed in the depression or anxiety DSM–IV categories. The severity was moderate in 40.1 % and 66.6% were chronic (six or more months). No significant demographic differences were found with non-cases. Backache was the most frequent somatic presentation (71.4%).ConclusionsST in primary care is a much broader phenomenon than categories such as somatoform disorders reflect. It may be less influenced by sociodemographic factors, but more chronic than previously reported.

Somatisation in Primary Care in Spain

1996 ◽  
Vol 168 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Javier García-Campayo ◽  
Ricardo Campos ◽  
Guillermo Marcos ◽  
Ma Jesus Peréz-Echeverría ◽  
Antonio Lobo ◽  
...  
Keyword(s):  
Primary Care ◽  
Major Depressive Episode ◽  
Generalised Anxiety Disorder ◽  
Major Depressive ◽  
Demographic Differences ◽  
Two Phase ◽  
Diagnostic Categories ◽  
Primary Care Patients ◽  
Patient Groups ◽  
Dsm Iv

BackgroundThis study is the first attempt to document the differences between somatisers (STs) and psychologisers (PGs) in Spanish primary care patients.MethodA sample of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, were examined in a two-phase screening using Spanish versions of GHQ–28, CAGE questionnaire, substance abuse, MMSE and SPPI. STs and PGs were diagnosed according to operationalised Bridges & Goldbergs criteria.ResultsST was found to be three times more prevalent than PG, but the ratio ST: PG was highest (10.5) in the DSM–IV category dysthymia. Generalised anxiety disorder was the most frequent diagnosis in STs and major depressive episode the most frequent in PGs. No significant differences between the two groups have been found in demographic characteristics. Total GHQ scores were significantly higher in PGs, but global SPPI scores were not. Most psychopathological scores were higher in PGs, but both somatic symptoms and suspiciousness were higher in STs. The psychopathological findings are consistent with hypotheses related to blame avoidance and defensiveness in STs.ConclusionsST is three times more prevalent than PG, but the ratio ST: PG depends heavily on diagnostic categories. While most psychopathological scores are higher in PGs, both patient groups are similarly disturbed. Previously assumed socio-demographic differences between STs and PGs have not been found in this study.

scholarly journals Type of Tea Consumption and Mild Cognition Impairment in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 296-296
Author(s):  
Yao Yao ◽  
Huashuai Chen ◽  
Danan Gu ◽  
Yi Zeng
Keyword(s):  
Green Tea ◽  
Mini Mental State Examination ◽  
Sociodemographic Factors ◽  
Tea Consumption ◽  
Cognitive Health ◽  
Logistic Regressions ◽  
Nationally Representative ◽  
Tea Drinking ◽  
Cognition Impairment ◽  
State Examination

Abstract Existing studies have testified the neuroprotective qualities of tea. As there are several types of tea, question on which type of tea may exert substantial influence on cognitive health is intriguing and remains unknow. We aim to estimate the association between type of tea consumption and mild cognition impairment (MCI) using a nationally representative dataset of older population in China. Type of tea consumption was classified as three groups: Green, fermented (White, Oolong, Black, and Pu’eh), and flower tea. The Mini-Mental State Examination (MMSE) was adopted to assess cognitive function. We conducted multivariate logistic regressions to evaluate the association between type of tea drinking and cognition outcomes (MMSE score and MCI). Potential confounders including sociodemographic factors, health conditions, dietary patterns, lifestyles, activities of daily living, mental health, and living environments. A total of 10,923 participants (mean age: 85.4 yr; female: 53.5%) included in the study. The type of current tea consumption among the participants were: 2143 for green tea, 1302 for fermented tea, and 844 for flower tea. Compared to those who had no habit of tea consumption, the odds ratio of MCI in green tea drinkers was 0.80 (0.68-0.95), in fermented tea drinkers was 1.07 (0.89-1.30), and in flower tea drinkers were 0.85 (0.67-1.09). Our study showed green tea and flower tea consumption associated with lower odds of MCI, while the association was not found among fermented tea drinkers. Future experimental and longitudinal studies are warranted to illustrate the association between varied type of tea and cognitive health.

Assessment

2017 ◽  
pp. 35-70
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Primary Care ◽  
Physical Examination ◽  
Therapeutic Relationship ◽  
Mental State ◽  
Assessment Methods ◽  
Assessment Process ◽  
Psychiatric Assessment ◽  
Psychiatric Interview ◽  
Detailed Review ◽  
State Examination

The psychiatric interview is at the heart of psychiatry, since it provides the cornerstone of diagnostic assessment as well as being central to establishing a therapeutic relationship. This chapter, ‘Assessment’, describes the goals, principles, and practice of psychiatric interviewing. There is a detailed review of the various components of a full psychiatric assessment (the history, mental state examination, physical examination and investigations), as well as descriptions of how the assessment process is tailored to suit different situations (e.g. in emergency departments, in primary care, or in the community). The chapter proceeds to discuss how the information collected during the assessment is recorded and communicated. The chapter ends with a description of the major standardized assessment methods and ratings scales used in psychiatry.

Use of benzodiazepines and cognitive performance in primary care patients with first cognitive complaints

2017 ◽  
Vol 30 (4) ◽  
pp. 597-601 ◽  
Author(s):  
G. Grande ◽  
I. Tramacere ◽  
D. L. Vetrano ◽  
S. Pomati ◽  
C. Mariani ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Performance ◽  
Mini Mental State Examination ◽  
Cognitive Complaints ◽  
Logistic Regression Models ◽  
Benzodiazepine Use ◽  
Primary Care Patients ◽  
Long Acting ◽  
The Impact ◽  
State Examination

ABSTRACTThe aim of the present study is to investigate the impact of benzodiazepine use on cognitive performance in primary care patients with first cognitive complaints. The association between the exposition to benzodiazepines (short and long half-life) and cognitive performance, evaluated through the Mini Mental State Examination (MMSE), was tested through analysis of the covariance and logistic regression models. Within the 4,249 participants (mean age 77.0 ± 8.2, 66.4% women), 732 (17%) were on benzodiazepines. When compared with non-users, short- and long-acting benzodiazepine users presented overlapping adjusted MMSE mean scores (respectively, mean MMSE score: 25.3, 95%CI 25.2–25.5; 25.4, 95%CI 25.1–25.7, and 25.9, 95%CI 25.3–26.4; p = 0.156). When tested according to the logistical regression model, after adjusting for potential confounders, no association was found between short and long acting benzodiazepine use and a MMSE < 24 (respectively, OR 0.9, 95%CI 0.7–1.2; OR 0.8, 95%CI 0.7–1.3) as compared with non-users. In conclusion, according to the results of our study, benzodiazepine use seems not to impact on cognitive performance- as assessed with the MMSE- of primary care patients referring to GPs for first cognitive complaints.

A meta-analysis of the accuracy of the Addenbrooke's Cognitive Examination (ACE) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) in the detection of dementia

2013 ◽  
Vol 26 (4) ◽  
pp. 555-563 ◽  
Author(s):  
Andrew J. Larner ◽  
Alex J. Mitchell
Keyword(s):  
Primary Care ◽  
Diagnostic Accuracy ◽  
Mini Mental State Examination ◽  
Meta Analysis ◽  
Screening Tools ◽  
High Prevalence ◽  
Memory Clinics ◽  
State Examination ◽  
Addenbrooke’S Cognitive Examination ◽  
Prevalence Of Dementia

ABSTRACTBackground:The Addenbrooke's Cognitive Examination (ACE) and its Revised version (ACE-R) are relatively new screening tools for cognitive impairment that may improve upon the well-known Mini-Mental State Examination (MMSE) and other brief batteries. We systematically reviewed diagnostic accuracy studies of ACE and ACE-R.Methods:Published studies comparing ACE, ACE-R and MMSE were comprehensively sought and critically appraised. A meta-analysis of suitable studies was conducted.Results:Of 61 possible publications identified, meta-analysis of qualifying studies encompassed 5 for ACE (1,090 participants) and 5 for ACE-R (1156 participants); of these, 9 made direct comparisons with the MMSE. Sensitivity and specificity of the ACE were 96.9% (95% CI = 92.7% to 99.4%) and 77.4% (95% CI = 58.3% to 91.8%); and for the ACE-R were 95.7% (95% CI = 92.2% to 98.2%) and 87.5% (95% CI = 63.8% to 99.4%). In a modest prevalence setting, such as primary care or general hospital settings where the prevalence of dementia may be approximately 25%, overall accuracy of the ACE (0.823) was inferior to ACE-R (0.895) and MMSE (0.882). In high prevalence settings such as memory clinics where the prevalence of dementia may be 50% or higher, overall accuracy again favored ACE-R (0.916) over ACE (0.872) and MMSE (0.895).Conclusions:The ACE-R has somewhat superior diagnostic accuracy to the MMSE while the ACE appears to have inferior accuracy. The ACE-R is recommended in both modest and high prevalence settings. Accuracy of newer versions of the ACE remain to be determined.

scholarly journals A Conformation Variant of p53 Combined with Machine Learning Identifies Alzheimer Disease in Preclinical and Prodromal Stages

2020 ◽  
Vol 11 (1) ◽  
pp. 14
Author(s):  
Giulia Abate ◽  
Marika Vezzoli ◽  
Letizia Polito ◽  
Antonio Guaita ◽  
Diego Albani ◽  
...  
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Mini Mental State Examination ◽  
Amnestic Mild Cognitive Impairment ◽  
Learning Approach ◽  
Plasma Samples ◽  
Primary Care Settings ◽  
Starting Point ◽  
Machine Learning Approach ◽  
State Examination

Early diagnosis of Alzheimer’s disease (AD) is a crucial starting point in disease management. Blood-based biomarkers could represent a considerable advantage in providing AD-risk information in primary care settings. Here, we report new data for a relatively unknown blood-based biomarker that holds promise for AD diagnosis. We evaluate a p53-misfolding conformation recognized by the antibody 2D3A8, also named Unfolded p53 (U-p532D3A8+), in 375 plasma samples derived from InveCe.Ab and PharmaCog/E-ADNI longitudinal studies. A machine learning approach is used to combine U-p532D3A8+ plasma levels with Mini-Mental State Examination (MMSE) and apolipoprotein E epsilon-4 (APOEε4) and is able to predict AD likelihood risk in InveCe.Ab with an overall 86.67% agreement with clinical diagnosis. These algorithms also accurately classify (AUC = 0.92) Aβ+—amnestic Mild Cognitive Impairment (aMCI) patients who will develop AD in PharmaCog/E-ADNI, where subjects were stratified according to Cerebrospinal fluid (CSF) AD markers (Aβ42 and p-Tau). Results support U-p532D3A8+ plasma level as a promising additional candidate blood-based biomarker for AD.

Mental Status and Neuropsychological Assessment: Discussion

1997 ◽  
Vol 9 (S1) ◽  
pp. 143-150
Author(s):  
Alistair Burns
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Mini Mental State Examination ◽  
American Family ◽  
The Core ◽  
The Usa ◽  
The Individual ◽  
High Level ◽  
State Examination ◽  
Quantitative Assessments

Ham: There seems to be an astonishing range of expectation from this group as to what a general practitioner (GP) will do for his or her patients, ranging from screening only through to being the primary manager. I feel that we are expecting a fairly high level of sophistication from the GPs within an average British, Canadian, or American family practice. I think we need to be aware that, for some time, the core recommendation in the USA has been to assess the patient using the Mini-Mental State Examination (MMSE) or the Clock Test and perhaps two or three other quantitative assessments. Noncognitive features, such as behavior, are harder to quantify and the individual who assesses them must be the patient's primary manager. It will increasingly happen in the USA that as care becomes more managed, a greater emphasis will be put upon primary care.

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